Brachytherapy device having seed tubes with individually-settable tissue spacings

CROSS-REFERENCE TO RELATED APPLICATIONS

0001This application claims priority to U.S. Provisional Patent Application Ser. No. 60/864,288, entitled “Brachytherapy Device Having Seed Tubes With Individually-Settable Tissue Spacing,” filed Nov. 3, 2006. This application is also related to U.S. patent application Ser. No. 11/305,437, entitled “Brachytherapy Apparatus,” filed Dec. 16, 2005, and U.S. Continuation application Ser. No. 11/379,739, entitled “Brachytherapy Apparatus for Asymmetrical Cavities,” filed Apr. 21, 2006 now abandoned. The contents of all of these applications are incorporated herein by reference in their entirety.

BACKGROUND

00021. Field

0003This application relates to brachytherapy.

00042. Description of Related Art

0005Brachytherapy is used in a variety of treatments. Often times, a high dose of radiation is needed. However, it may be difficult to apply a high dose to areas in need of treatment, without also causing damage to healthy tissue in the vicinity.

SUMMARY

0006A brachytherapy device may include a plurality of rods, each configured to move between a straightened position and a bowed position, the plurality of rods configured to collectively form a shaft while each rod is in the straightened position and to collectively form at least one cage while at least some of the rods are in the bowed position, at least some of the rods having lumens that are configured to receive and hold radioactive material. A brachytherapy device may further include a rotatable mechanism configured to cause at least some of the plurality of rods to move between the straightened position and the bowed position upon rotation of the rotatable mechanism.

0007A brachytherapy device may comprise a plurality of rods, each configured to move between a straightened position and a bowed position, the plurality of rods configured to collectively form a shaft while each rod is in the straightened position and to collectively form at least one cage while at least some of the rods are in the bowed position, at least some of the rods having lumens that are configured to receive and hold radioactive material, wherein some of the rods are configured to form a first cylinder while in the straightened position and the other rods are configured to form a second cylinder while in the straightened position that surrounds the first cylinder, whereby the plurality of rods are further configured such that at least a substantial portion of each the rod in the second cylinder lies between two rods within the first cylinder while in the straightened position.

0008A brachytherapy device may further comprise a plurality of rods, each configured to move between a straightened position and a bowed position, the plurality of rods configured to collectively form a shaft while each rod is in the straightened position and to collectively form at least one cage while at least some of the rods are in the bowed position, at least some of the rods having lumens that are configured to receive and hold radioactive material, wherein each rod has opposing longitudinal edges, each of which is configured to interlock with a longitudinal edge of a neighboring rod while in the straightened position.

0009A brachytherapy device may include a first and a second set of rods, at least some of the rods having lumens that are configured to receive and hold radioactive material. A brachytherapy device may further include a group expansion mechanism associated with the first set of rods and configure to collectively move the first set of rods in unison, each between a straightened position and a bowed position, the first set of rods configured to collectively form a shaft while each of the first set of rods is in the straightened position and to collectively form a cage while each of the first set of rods is in the bowed position. A brachytherapy device may further include a rod bowing mechanism associated with each of the second set of rods and configured to individually move each of the second set of rods between a straightened and a bowed position, the second set of rods configured to collectively form a shaft while each of the second set of rods is in the straightened position.

0010A brachytherapy device may include a plurality of rods configured to move between a straightened position and a bowed position, the rods configured to collectively form a shaft while each of the second set of rods is in the straightened position, at least some of the rods having lumens configured to receive and hold radioactive material. A brachytherapy device may further include a plurality of actuators, each associate with one of the rods and configured to cause the rod with which it is associated to move from the straightened position to the bowed position in incremental steps, each of the incremental steps being delineated by a ratchet mechanism.

0011These, as well as other components, steps, features, objects, benefits, and advantages, will now become clear from a review of the following detailed description of illustrative embodiments and the accompanying drawings.

BRIEF DESCRIPTION OF DRAWINGS

0012The drawings disclose illustrative embodiments. They do not set forth all embodiments. Other embodiments may be used in addition or instead. Details that may be apparent or that are unnecessary are also often omitted to save space or for more effective illustration. When the same numeral appears in different drawings, it is intended to refer to the same or like components or steps.

0013<figref idref="DRAWINGS">FIG. 1</figref> illustrates a pre-expander balloon apparatus.

0014<figref idref="DRAWINGS">FIG. 2</figref> illustrates the pre-expander balloon apparatus inserted into a cavity of a breast and inflated.

0015<figref idref="DRAWINGS">FIG. 3</figref> illustrates a sleeve having a flanged end.

0016<figref idref="DRAWINGS">FIG. 4</figref> illustrates the sleeve being cut by a cutting tool.

0017<figref idref="DRAWINGS">FIG. 5</figref> illustrates a trocar being inserted into the sleeve.

0018<figref idref="DRAWINGS">FIG. 6</figref> illustrates the trocar after it has been inserted through the sleeve.

0019<figref idref="DRAWINGS">FIG. 7</figref> illustrates the trocar and sleeve after they have been inserted into the resected cavity of the breast.

0020<figref idref="DRAWINGS">FIG. 8</figref> illustrates the sleeve inserted into the breast after the trocar has been removed.

0021<figref idref="DRAWINGS">FIG. 9</figref> illustrates a tube apparatus being inserted into a distal end of the sleeve.

0022<figref idref="DRAWINGS">FIG. 10</figref> is an enlarged view of the tube apparatus.

0023<figref idref="DRAWINGS">FIG. 11</figref> illustrates the tube apparatus with its outer tubes partially expanded.

0024<figref idref="DRAWINGS">FIG. 12</figref> illustrates the tube apparatus with the outer tubes more fully expanded.

0025<figref idref="DRAWINGS">FIG. 13</figref> illustrates the tube apparatus with the outer tubes expanded within the cavity in the breast.

0026<figref idref="DRAWINGS">FIG. 14(</figref><i>a</i>) illustrates the tube apparatus with the outer tubes expanded and with a set of inner tubes individually expanded within the cavity in the breast.

0027<figref idref="DRAWINGS">FIG. 14(</figref><i>b</i>) is an enlarged perspective view of the proximate end of the tube apparatus.

0028<figref idref="DRAWINGS">FIG. 14(</figref><i>c</i>) is an enlarged perspective view of the distal end of tubes in the tube apparatus.

0029<figref idref="DRAWINGS">FIG. 14(</figref><i>d</i>) illustrates an end view of the expanded inner and outer tubes.

0030<figref idref="DRAWINGS">FIG. 15</figref> illustrates a cross-section of a handle of the tube apparatus.

0031<figref idref="DRAWINGS">FIG. 16</figref> illustrates a perspective view of the cross-section of the handle.

0032<figref idref="DRAWINGS">FIG. 17</figref> illustrates an enlarged perspective view of the cross-section of the handle.

0033<figref idref="DRAWINGS">FIG. 18</figref> illustrates a hemostat being used to lock the tubes in their expanded positions.

0034<figref idref="DRAWINGS">FIG. 19</figref> illustrates the handle being cut from the tubes by a cutting tool.

0035<figref idref="DRAWINGS">FIG. 20</figref> illustrates the tubes while locked and after being separated from the handle.

0036<figref idref="DRAWINGS">FIG. 21</figref> illustrates an adapter being positioned for attachment to the sleeve.

0037<figref idref="DRAWINGS">FIG. 22</figref> illustrates the adapter attached to the sleeve.

0038<figref idref="DRAWINGS">FIG. 23</figref> illustrates a cap attached to the distal end of the sleeve.

0039<figref idref="DRAWINGS">FIG. 24</figref> illustrates a hemostat being used to unlock the tubes.

0040<figref idref="DRAWINGS">FIG. 25</figref> illustrates the hemostat being used to straighten the tubes.

0041<figref idref="DRAWINGS">FIG. 26</figref> illustrates the hemostat being used to grab the tubes after they have been straightened.

0042<figref idref="DRAWINGS">FIG. 27</figref> illustrates the straightened tubes being removed from the sleeve by the hemostat.

0043<figref idref="DRAWINGS">FIG. 28</figref> illustrates the sleeve being removed from the breast.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

0044Illustrative embodiments are now discussed. Other embodiments may be used in addition or instead. Details that may be apparent or that are unnecessary are also often omitted to save space or for more effective presentation.

0045<figref idref="DRAWINGS">FIG. 1</figref> illustrates a pre-expander balloon apparatus. As shown in <figref idref="DRAWINGS">FIG. 1</figref>, the pre-expander balloon apparatus may include a balloon <b>101</b>—illustrated in a deflated state—an inflation tube <b>103</b>, and an inflation applicator <b>105</b>.

0046The balloon <b>101</b> may be configured to inflate with gas or fluid. The inflation tube <b>103</b> may be configured to carry the gas or fluid from the inflation applicator <b>105</b> to the balloon <b>101</b>. The inflation applicator <b>105</b> may include a reservoir cylinder <b>107</b> and a plunger <b>109</b> which may contain the gas or fluid. Any type of gas or fluid may be used. In one embodiment, saline may be used.

0047<figref idref="DRAWINGS">FIG. 2</figref> illustrates the pre-expander balloon apparatus inserted into a cavity <b>201</b>. The cavity <b>201</b> may be a cavity in any area of a body, such as in a breast <b>205</b>. It may be a cavity formed by the extraction of a cancerous tumor or that exists for any other reason.

0048The balloon <b>101</b> while in its deflated state may be inserted through an opening <b>207</b> in the skin surface of the breast <b>205</b> and into the cavity <b>201</b>. The opening <b>207</b> and the pathway to the cavity may have been created during the resection of the tumor or at any other time. Once in the cavity, the balloon <b>101</b> may be expanded by applying force to the plunger <b>109</b> while retaining a grasp of tabs <b>108</b> on the reservoir cylinder <b>107</b>.

0049The balloon <b>101</b> may be inflated until it substantially fills the cavity. An X-ray or CT scan may be used to determine when this point has been reached.

0050The distance between the opening <b>207</b> on the skin surface and the initial entry point <b>209</b> to the cavity <b>201</b> may be measured. For this purpose, the inflation tube <b>103</b> may be marked with gradations. The gradation that is closest to the opening <b>207</b> on the inflation tube <b>103</b> may be noted and this measurement may be recorded for later use.

0051The inflation applicator <b>105</b> may be detached from the inflation tube <b>103</b> and the inflation tube <b>103</b> may be sealed so that the balloon <b>101</b> remains inflated. The inflated balloon <b>101</b> may be left within the cavity <b>201</b> until the patient is ready for radiation treatment.

0052When the patient is ready for radiation treatment, the inflation tube <b>103</b> may be reopened at its distal end, thus allowing the balloon <b>101</b> to deflate. The balloon <b>101</b> and the inflation tube <b>103</b> may then be removed from the breast <b>205</b>.

0053<figref idref="DRAWINGS">FIG. 3</figref> illustrates a sleeve <b>301</b> having a flanged end <b>303</b>. Before use, the length of the sleeve <b>301</b> may be trimmed to the initial depth of the cavity <b>201</b>. As explained above, this measurement may have already been made by noting the gradation on the inflation tube <b>103</b> that was at the surface of the skin. It may have been made by other means or may be made now.

0054<figref idref="DRAWINGS">FIG. 4</figref> illustrates the sleeve <b>301</b> being cut by a cutting tool <b>401</b>. The cutting tool <b>401</b> may have a cutting blade <b>403</b> and may be positioned to cut the sleeve <b>301</b> at a length that is approximately equal to the initial depth of the cavity within the breast <b>205</b>.

0055<figref idref="DRAWINGS">FIG. 5</figref> illustrates a trocar <b>501</b> being inserted into the sleeve <b>301</b>.

0056<figref idref="DRAWINGS">FIG. 6</figref> illustrates the trocar <b>501</b> after it has been inserted through the sleeve <b>301</b>.

0057The trocar <b>501</b> and the sleeve <b>301</b> may be inserted into the cavity <b>201</b> of the breast <b>205</b>, as shown in <figref idref="DRAWINGS">FIG. 7</figref>. The sleeve <b>301</b> may be pushed into the breast until its flanged end abuts the surface of the skin and its proximate end reaches the initial entry point <b>209</b> into the cavity.

0058<figref idref="DRAWINGS">FIG. 8</figref> illustrates the sleeve <b>301</b> inserted into the breast <b>205</b> after the trocar <b>501</b> has been removed. The flanged end <b>303</b> of the sleeve <b>301</b> may be sutured to the breast at this time.

0059<figref idref="DRAWINGS">FIG. 9</figref> illustrates a tube apparatus <b>901</b> being inserted into a distal end <b>903</b> of the sleeve <b>301</b>. The tube apparatus <b>901</b> may continue to be inserted into the sleeve <b>301</b> until its proximate end <b>905</b> passes through the proximate end <b>907</b> of the sleeve <b>301</b> and is stopped from further free movement by the opposite end <b>909</b> of the cavity <b>201</b>.

0060Trimming the sleeve <b>301</b> to the initial depth of the cavity <b>201</b> and inserting the tube apparatus <b>901</b> into the cavity <b>201</b> until its proximate end <b>905</b> engages the opposite end <b>909</b> of the cavity <b>201</b> may cause the tube apparatus <b>901</b> to protrude beyond the proximate end <b>907</b> of the sleeve <b>301</b> by an amount that is approximately equal to the diameter of the cavity <b>201</b> and to be approximately centered within the cavity <b>201</b>. In this way, a single sized tube apparatus <b>901</b> may be used to treat cavities of varying size, as will become apparent from the discussion below.

0061<figref idref="DRAWINGS">FIG. 10</figref> is an enlarged view of the tube apparatus <b>901</b>. The tube apparatus <b>901</b> may include a set of tubes <b>1001</b> positioned within the sleeve <b>301</b> and attached to a handle <b>1003</b>.

0062The set of tubes <b>1001</b> may include any number of tubes bundled together. The proximate ends <b>1005</b> of the tubes <b>1001</b> may be bound together using any means, such as glue or an ultrasonic bond.

0063The tubes <b>1001</b> may be made of any material, including material that is normally straight, but resiliently flexes after longitudinal compression. Plastic or any other type of material may be used. A central lumen may or may not be provided within one, some or all of the tubes <b>1001</b>.

0064The tubes <b>1001</b> may be of any number. Twelve will be discussed. A different number, such as <b>4</b>, <b>5</b>, <b>6</b>, <b>7</b>, <b>8</b>, <b>9</b>, <b>10</b>, <b>11</b>, <b>13</b>, <b>14</b>, <b>15</b>, <b>16</b>, etc. may be used instead.

0065<figref idref="DRAWINGS">FIG. 11</figref> illustrates the tube apparatus with its outer tubes <b>1107</b> partially expanded. The outer tubes <b>1107</b> constitute an outer portion of the tubes <b>1001</b>.

0066A gear <b>1105</b> may mesh with threads <b>1101</b> on a collar <b>1102</b> that may be attached to distal ends of the outer tubes <b>1107</b>. A rod <b>1109</b> may run through the center of the tubes <b>1001</b> and may be attached at its proximate end to the proximate end <b>1005</b> of the tubes <b>1001</b> and at its distal end to an end <b>1111</b> of the handle <b>1003</b>. Any means may be used to effectuate this attachment, such as glue or ultrasonic bonding.

0067When the gear <b>1105</b> is rotated with respect to the handle <b>1003</b>, this may cause the collar <b>1102</b> to move laterally away from the handle <b>1003</b> and to apply a longitudinal compressive force to the outer tubes <b>1107</b>, thus causing them to expand in unison as show in <figref idref="DRAWINGS">FIG. 11</figref>.

0068<figref idref="DRAWINGS">FIG. 12</figref> illustrates the tube apparatus the outer tubes <b>1107</b> more fully expanded. As shown in <figref idref="DRAWINGS">FIG. 12</figref>, the collar <b>1102</b> has been separated even further from the handle <b>1003</b> by continued rotation of the gear <b>1105</b> with respect to the handle <b>1003</b>. This relative rotation may continue until the outer tubes <b>1107</b> substantially fill the cavity <b>201</b> in the breast <b>205</b>. During some procedures, the rotation may be halted before this point is reached. During other procedures, the rotation may continue past this point.

0069<figref idref="DRAWINGS">FIG. 13</figref> illustrates the tube apparatus with the outer tubes <b>1107</b> expanded within the cavity <b>201</b> in the breast <b>205</b>. An X-ray or CT scan may be taken to verify that the outer tubes <b>1107</b> have been expanded to the desired amount and/or to provide information about adjustments that may be needed.

0070The number of the outer tubes <b>1107</b> may vary. Six are illustrated in <figref idref="DRAWINGS">FIG. 13</figref>. A different number may be used, such as <b>3</b>, <b>4</b>, <b>5</b>, <b>7</b>, or <b>8</b>. The outer tubes <b>1107</b> may be oriented so that they are evenly distributed around the perimeter of the rod <b>1109</b>, or they may be distributed in an uneven manner.

0071<figref idref="DRAWINGS">FIG. 14(</figref><i>a</i>) illustrates the tube apparatus with the set of outer tubes <b>1107</b> expanded and with a set of inner tubes <b>1401</b> individually expanded within the cavity <b>20</b>. Thumb sliders <b>1403</b> may each be separately attached to one of the inner tubes <b>1401</b>. Each of the thumb sliders <b>1403</b> may be slid forward with respect to the handle <b>1003</b>, causing longitudinal compression of the inner tube to which it is attached. This may cause the inner tube to bend outwardly. The amount of the bending may be a function of the degree to which the thumb slider is slid forward.

0072Each of the thumb sliders <b>1403</b> may include a ratchet or other type of mechanism that prevents the thumb slider from retreating, unless urged to do so by thumb pressure in the opposite direction.

0073Any number of inner tubes may be used for the set of inner tubes <b>1401</b>. Six are illustrated in <figref idref="DRAWINGS">FIG. 14(</figref><i>a</i>). A different number may be used, such as <b>1</b>, <b>2</b>, <b>3</b>, <b>4</b>, <b>5</b>, <b>7</b>, or <b>8</b>.

0074As illustrated in <figref idref="DRAWINGS">FIG. 14(</figref><i>a</i>), the outer tubes <b>1107</b> may surround the inner tubes <b>1401</b>. In turn, the inner tubes <b>1107</b> may surround the rod <b>1109</b>. These surrounding relationships may also exist when the tubes <b>1001</b> are in their uncompressed positions illustrated in <figref idref="DRAWINGS">FIG. 10</figref>. In another embodiment, the outer tubes <b>1107</b> and the inner tubes <b>1401</b> may all be at approximately the same radial position from the rod <b>1109</b> when in the uncompressed position shown in <figref idref="DRAWINGS">FIG. 10</figref>.

0075The outer tubes <b>1107</b> may be equal in number to the inner tubes <b>1401</b>, as illustrated in <figref idref="DRAWINGS">FIG. 14(</figref><i>a</i>). There may instead be more outer tubes than inner tubes or less.

0076The amount of bowing in each of the inner tubes <b>1401</b> that is caused by the sliding of its respective thumb slider may vary from procedure to procedure. The criteria that is employed for determining the amount may also vary.

0077During some procedures, all of the inner tubes <b>1401</b> may initially be bowed in the same amount in accordance with predetermined information, such as a formula, algorithm, or specification. This predetermined information may be dependent upon the particular patient and his or her situation. Alternately, it may be patient independent.

0078After initially bowing each of the inner tubes <b>1401</b> to this predetermined amount, adjustments may be made to one or more of the inner tubes <b>1401</b> to protect healthy tissue and/or to increase the dose to certain areas of the cavity <b>201</b>. For example, the bowing of one or more of the inner tubes <b>1401</b> may be individually reduced by moving its respective thumb slider backwards so as to better protect healthy tissue in its vicinity, such as skin, a lung or the heart. Similarly, the bowing of one or more of the inner tubes <b>1401</b> may be individually increased by moving its respective thumb slider forwards so as to apply a greater dose to tissue in its vicinity.

0079<figref idref="DRAWINGS">FIG. 14(</figref><i>b</i>) is an enlarged perspective view of the proximate end of the tube apparatus. It reveals details of the outer tubes <b>1107</b>, the inner tubes <b>1401</b>, the rod <b>1109</b>, and the proximate end <b>1005</b>.

0080<figref idref="DRAWINGS">FIG. 14(</figref><i>c</i>) is an enlarged perspective view of the distal end of the tubes <b>1001</b> before they are inserted into the handle <b>1003</b>. It reveals details of interlocking flanges between each of the outer tubes <b>1107</b>, such as interlocking flanges <b>1402</b> and <b>1404</b>, and between each of the inner tubes <b>1401</b>, such as interlocking flanges <b>1406</b> and <b>1408</b>. These interlocking flanges allow each of the tubes to slide separately with respect to its neighbors, while minimizing leaks. <figref idref="DRAWINGS">FIG. 14(</figref><i>c</i>) also illustrates lumens that may run though the approximate center of each of the tubes <b>1001</b>, such as lumen <b>1410</b>. It also illustrates nesting between the inner tubes <b>1401</b> and the outer tubes <b>1107</b>. This nesting may allows the outer tubes <b>1107</b> to slide longitudinally with respect to the inner tubes <b>1401</b>.

0081<figref idref="DRAWINGS">FIG. 14(</figref><i>d</i>) is an end view of the expanded inner tubes <b>1401</b> and outer tubes <b>1107</b>. As illustrated in <figref idref="DRAWINGS">FIG. 14(</figref><i>d</i>), each of the outer tubes <b>1107</b> may be bowed to the same degree and in an amount that is greater than the bowing of each of the inner tubes <b>1401</b>. Although the bowing of each of the inner tubes <b>1401</b> is illustrated as being substantially the same in <figref idref="DRAWINGS">FIG. 14(</figref><i>d</i>), there may be substantial variation among the bowing of each of the inner tubes <b>1401</b>, as discussed above.

0082<figref idref="DRAWINGS">FIG. 15</figref> illustrates a cross-section of the handle <b>1003</b>.

0083<figref idref="DRAWINGS">FIG. 16</figref> illustrates a perspective view of the cross-section of the handle <b>1003</b> shown in <figref idref="DRAWINGS">FIG. 15</figref>. As shown in <figref idref="DRAWINGS">FIG. 16</figref>, ratchet teeth <b>1601</b> may cooperate with one of the thumb sliders <b>1403</b> to lock it in position after forward movement.

0084<figref idref="DRAWINGS">FIG. 17</figref> is an enlarged perspective view of the cross-section of the handle <b>1003</b>. <figref idref="DRAWINGS">FIG. 17</figref> illustrates further details, including the interlocking relationship between each of the thumb sliders <b>1403</b> and the inner tube to which it applies longitudinal compressive force.

0085<figref idref="DRAWINGS">FIG. 18</figref> illustrates a hemostat <b>1801</b> being used to lock the tubes <b>1001</b> in their bowed positions. A locking clamp <b>1803</b> may surround the tubes <b>1001</b> at the flanged end <b>303</b>. Closure of the hemostat <b>1801</b> may cause the locking clamp <b>1803</b> to compress the tubes <b>1001</b> at this location, thus retaining their bowed positions.

0086<figref idref="DRAWINGS">FIG. 19</figref> illustrates the handle <b>1103</b> being cut from the tubes <b>1001</b> by a cutting tool <b>1901</b>. A cutting blade of the cutting tool <b>1901</b> may be positioned just beyond the distal end of the locking clamp <b>1803</b> and pressed against the tubes <b>1001</b>.

0087<figref idref="DRAWINGS">FIG. 20</figref> illustrates the tubes <b>1001</b> while locked and after having been separated from the handle <b>1103</b>.

0088<figref idref="DRAWINGS">FIG. 21</figref> illustrates an adaptor <b>2101</b> being positioned for attachment to the sleeve <b>301</b>. The adaptor <b>2101</b> may be any type of adaptor that may be configured to function with any type afterloader.

0089<figref idref="DRAWINGS">FIG. 22</figref> illustrates the adaptor <b>2101</b> attached to the sleeve <b>301</b>. Any type of snap or interlocking device may be used for this purpose.

0090The adaptor <b>2101</b> may include a plurality of adapter tubes <b>2203</b>. Each of the adapter tubes <b>2203</b> may be joined at the juncture between the adaptor <b>2101</b> and the sleeve <b>301</b> to one of the inner tubes <b>1401</b> so as to create a continuous central lumen from the distal ends <b>2205</b> of each of the adaptor tubes <b>2203</b> to the proximate end <b>1005</b> of the inner tubes <b>1401</b>.

0091The distal ends <b>2205</b> may be coupled to any type of afterloader. The afterloader may be configured to inject one or more strands, each containing one or more radioactive seeds, into the distal end of one or more of the adaptor tubes <b>2203</b> and into one or more of the inner tubes <b>1401</b>. The precise position of each radioactive seed within each of the inner tubes <b>1401</b> may be regulated by the afterloader, as well as the dwell time at each position.

0092The afterloader may be programmed to cause a single radioactive seed within a single strand to be sequentially injected into one or more of the inner tubes <b>1401</b> at one or more specified locations for one or more specified dwell times. Any type or combination of types of radiation treatment may be employed.

0093After completion of the radiation treatment, the adaptor <b>2101</b> may be detached from the sleeve <b>301</b> and a cap may be placed on the distal end of the sleeve <b>301</b> to protect it.

0094<figref idref="DRAWINGS">FIG. 23</figref> illustrates a cap <b>2301</b> attached to the distal end of the sleeve <b>301</b>. The cap <b>2301</b> may remain attached until the next treatment is administered. At this time, the cap <b>2301</b> may be removed and the process described above in connection with <figref idref="DRAWINGS">FIGS. 21 and 22</figref> may be repeated in the same or in a different way.

0095After one or more radiation treatments, the tube apparatus that is shown in <figref idref="DRAWINGS">FIG. 21</figref> may be removed. <figref idref="DRAWINGS">FIG. 24</figref> illustrates the hemostat <b>2401</b> being used to unlock the locking clamp <b>1803</b>. After the locking clamp <b>1803</b> is unlocked, the tubes may naturally tend to go back to their straightened position.

0096<figref idref="DRAWINGS">FIG. 25</figref> illustrates the hemostat <b>2401</b> being used to straighten the tubes <b>1001</b>. As shown in <figref idref="DRAWINGS">FIG. 25</figref>, the tubes may not fully straighten on their own. By pulling them distally with the hemostat <b>2401</b>, they may be completely straightened.

0097<figref idref="DRAWINGS">FIG. 26</figref> illustrates the hemostat <b>2401</b> being used to grab the tubes <b>1001</b> after they have been completely straightened.

0098<figref idref="DRAWINGS">FIG. 27</figref> illustrates the straightened tubes <b>1001</b> being removed from the sleeve <b>301</b> by the hemostat <b>2401</b>. Thereafter, the sleeve <b>301</b> may be removed from the breast.

0099<figref idref="DRAWINGS">FIG. 28</figref> illustrates the sleeve <b>301</b> being removed from the breast <b>205</b>. The opening <b>207</b> in the breast <b>205</b> may then be sutured and allowed to heal.

0100The components, steps, features, objects, benefits and advantages that have been discussed are merely illustrative. None of them, nor the discussions relating to them, are intended to limit the scope of protection in any way. Numerous other embodiments are also contemplated, including embodiments that have fewer, additional, and/or different components, steps, features, objects, benefits and advantages. The components and steps may also be arranged and ordered differently.

0101For example, the device and procedures that have been described may be used in conjunction with brachytherapy treatments for tissue other than breast tissue, such as for the brain and/or the prostate. Although a strand with one or more radioactive seeds has thus-far been described as being inserted into the inner tubes <b>1401</b>, one or more strands containing one or more seeds may in addition or instead be inserted into a lumen in one or more of the outer tubes <b>1107</b>.

0102Apparatus may be provided that facilitates bowing of one or more members of the outer tubes <b>1107</b> on an individual basis, rather than bowing in unison as has been described.

0103Different types of devices and apparatuses may be used for the tubes, to control and/or regulate their movement, and/or to feed them with radioactive seeds, then have been described. A radioactive source other than a seed may be used in addition or instead.

0104The patent applications that have been incorporated by reference in the Cross-Reference to Related Applications section of this application disclose a broad variety of related devices, components, and procedures. One or more of these may be used in conjunction with the devices, components, and/or procedures that are described in this application and/or in lieu of some or all of them.

0105Nothing that has been stated or illustrated is intended to cause a dedication of any component, step, feature, object, benefit, advantage, or equivalent to the public.